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Home My WebLink AboutBuilding Permit #260-15 - 15 WINTERGREEN DRIVE 9/15/2014 BUILDING PERMIT of "O RTH TOWN OF NORTH ANDOVER �� y��1- - "•, �0 O L .,. APPLICATION FOR PLAN EXAMINATION h T Permit No#: V �( � Date Received �SSACHU`�� Date Issued: ORTANT: Applicant must complete all items on this page r ` LOCATION A� - 1 Pnnt PROPERTY OWNER asnN Pnnt M..._ _ loo Year structure yes Enio) _r MAP1D PARCEL: ZONING DISTRICT. _ - Historic District yes Machine Shop Village yes TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building ❑ One family ❑Addition ❑Two or more family ❑ Industrial ❑Alteration No. of units: ❑ Commercial ❑ Repair, replacement ❑Assessory Bldg ❑ Others: ❑ Demolition ❑ Other ❑ Septic ❑Well ❑ Floodplain li Wetlands D Watershed District ❑Water/Sewer DESCRIPTION OF WORK TO BE PERFORME Ldwitification- PI ase Type or Print Clearly OWNER: Name: �1ar,� Phone: —d7 Address: is W r AlJoseE O -� Contractor Name: ___ "Phone:_ one:_ _. Address: Supervisor's Construction License: _ _ Exp. Date: - Home Improvement License --_ __ _Exp. Date: ARCHITECT/ENGINEER Phone: Address: Reg. No. T• FEE SCHEDULE.BULDING PERMIT.$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost: $ „ FEE: $ Check No.: v;D7 -' a Receipt No.: o NOTE: Persons contracting ith:unregiste d contractors do not have access to the guarantyfund SigF nature of Agent/Owner Signature of contractor Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ TYPE'OF SEWERAGE DISPOSAL Public Sewer ❑ Tanning/Massage/Body Art ❑ Swimming Pools ❑ Well ❑ Tobacco Sales ❑ Food Packaging/Sales ❑ Private(septic tank,etc. ❑ Permanent Dumpster on Site ❑ THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF - U FORM PLANNING & DEVELOPMENT Reviewed On Signature_ COMMENTS CONSERVATION Reviewed on Signature COMMENTS a HEALTH Reviewed on -------1111-!r'llSi nature COMMENTS_ /p' Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Comments Conservation Decision: Comments Water& Sewer Connection/Signature& Date Driveway Permit DPW Town Engineer: Signature: Located 384 Osgood Street FIRE DEPARTMENT - Temp Dumpster on site yes- _ no Located at 12.4 Main Street Fire Department signature/date _ COMMENTS I i Dimension Number of Stories: Total square feet of floor area, based on Exterior dimensions. Total land area, sq. ft.: i ELECTRICAL: Movement of Meter location, mast or service drop requires approval of Electrical Inspector Yes No DANGER ZONE LITERATURE: Yes No + MGL Chapter 166 Section 21A—F and G min.$10o-$1000 fine NOTES and DATA— (For department use) ❑ Notified for pickup Call Email Date Time Contact Name Doc.Building Permit Revised 2014 I r- Building Department The following is a list of the required forms to be filled out for the appropriate permit to be obtained. Roofing, Siding, Interior Rehabilitation Permits ❑ Building Permit Application ❑ Workers Comp Affidavit ❑ Photo Copy Of H.I.C. And/Or C.S.L. Licenses ❑ Copy of Contract ❑ Floor Plan Or Proposed Interior Work ❑ Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit Addition Or Decks ❑ Building Permit Application ❑ Certified Surveyed Plot Plan ❑ Workers Comp Affidavit ❑ Photo Copy of H.I.C. And C.S.L. Licenses ❑ Copy Of Contract ❑ Floor/Cross Section/Elevation Plan Of Proposed Work With Sprinkler Plan And Hydraulic Calculations (If Applicable) ❑ Mass check Energy Compliance Report (If Applicable) ❑ Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit New Construction (Single and Two Family) ❑ Building Permit Application ❑ Certified Proposed Plot Plan ❑ Photo of H.I.C. And C.S.L. Licenses ❑ Workers Comp Affidavit ❑ Two Sets of Building Plans (One To Be Returned) to Include Sprinkler Plan And Hydraulic Calculations (If Applicable) ❑ Copy of Contract ❑ Mass check Energy Compliance Report ❑ Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg. Permit In all cases if a variance or special permit was required the Town Clerks office must stamp the decision from the Board of Appeals that the appeal period is over. The applicant must then get this recorded at the Registry of Deeds. One copy and proof of recording must be submitted with the building application Doc:Building Permit Revised 2014 c� Location V No. D Date '• l • . TOWN OF NORTH ANDOVER Certificate of Occupancy $ . _ Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee $ Ar I) N TOTAL $ Check# � 28013 Building Inspector NORTH Town of : ndover 0 No. ,� oh ver, Mass, cocN�cHewic« y1' �•9 A°RAreo S U BOARD OF HEALTH Food/Kitchen PERMIT T D Septic System • THIS CERTIFIES THAT 1..&csori.....dop...6...... BUILDING INSPECTOR has permission to erect .......................... buildingson ....� ............ Foundation.. ...�.�. .... ............ Rough to be occupied as ......1. ..�.r...... .11"A.!..... ......v'.4•4d�... ........ .. .�.....�� Chimney provided that the person accepting this permit shall in ever respect conform to the terms oT the application Final on file in this office, and to the provisions of the Codes and By-Laws relating to the Inspection, Alteration and Construction of Buildings in the Town of North Andover. PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough nA y c Final PERMIT EXPIRES IN 6 MONT ELECTRICAL INSPECTOR • UNLESS CONSTRUCTIO T S Rough 6 .............. Service ................ .... ..... ....................... Final BUILDING INSPECTOR GAS INSPECTOR Occupancy Permit Required to Occupy Buildinz Rough Display in a Conspicuous Place on the Premises - Do Not Remove Final No Lathing or Dry Wall To Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. Smoke Det. 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